Study Shows the Body Can Heal the Brain’s Reward System after Opiate Detoxification

The body’s natural reward systems may normalize within just a few months after opiate detoxification, according to a new study. The research suggests the brain and hormonal responses to pleasurable stimuli, disrupted by opiate abuse, begin returning to a normal state shortly after treatment.

Opiate drugs stimulate the opioid system, which controls pain, reward and addictive behaviors. In small doses, short courses of opiate drugs reduce pain and cause euphoria in very pleasurable ways. Large doses of opiates or continual opiate use causes overstimulation of the opioid system, especially in reward centers of the brain.

With continued use, opiates lose their ability to stimulate reward. In fact, the reward centers of the brain become less sensitive to any sort of pleasurable stimuli. In time, the individual stops feeling fulfilled from the things that used to bring him pleasure. Some of these things include food, hobbies, interpersonal relationships and friendships. Eventually, the reward center ignores all pleasurable stimuli except for opiates.

Recovery from opiate abuse is difficult, especially when an individual gains no sense of reward and pleasure after overcoming the challenges of opiate detoxification and rehabilitation. The stunted sense of reward greatly increases the risk for relapse. Recovery specialists can hasten the opiate detoxification process and teach patients how to live without drugs. However, many scientists wondered if the opioid system and reward centers of the brain could recover.

Opiate Detoxification Allows the Reward System to Heal Itself

Researchers from Penn State University College of Medicine, Hershey, sought to find evidence of “physiological re-regulation” of disrupted brain and hormonal responses to pleasurable drug- and nondrug-related stimuli.

Scott C. Bunce, PhD, of and colleagues published their findings in the Journal of Addiction Medicine, the official journal of the American Society of Addiction Medicine. The study examined two groups of seven patients in a residential treatment facility for opiate dependence. One group underwent medically assisted detoxification within the previous one to two weeks. Participants in the second group were in an extended care facility and were drug-free for two to three months. Scientist also created a control group to use as comparison.

The scientists performed a variety of tests that could assess the changes in the brain’s reward system at various stages of recovery. The researchers examined several areas of the brain’s opioid system. This included the prefrontal cortex that is involved in attention and self-control.

The researchers found several significant differences in the reward system between the groups. The patients with recent opiate withdrawal had reduced pleasurable responses to natural reward stimuli, such as pictures of appetizing food or people having a good time. These individuals did show heightened pleasure responses associated with drug-related stimuli, such as photographs of pills.

Patients who had recently gone through opiate withdrawal had high levels of the stress hormone, cortisol. The researchers found the patients who had been drug-free for a few months had somewhat reduced cortisol levels, even though the cortisol levels of this group were not as good as participants in the healthy control group were. The group who had recently withdrawn from opiates also had sleep disturbances. Whereas, those who had been drug-free for months had sleep patterns similar to the control group.

All of the brain and hormone changes correlated with abstinence time. The longer a patient stays drug-free, the lower her rate of abnormal brain and hormonal responses.

The research supports the theory that if a person remains in treatment and off drugs for several months, his body’s natural reward system can return to normal capacity, making it easier for the patient to remain drug-free.

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